Helping a Bipolar Patient Transition to a Healthy Life
My sister-in-law Carey started living with us right after a three-month stay at an inpatient facility that helped her gain control of her bipolar disorder.
Since she moved into our house in February 2012, I think my wife, Diana, and I have worked well together to ease Carey's transition out of a highly structured environment and into a world where she is exposed to daily triggers that can easily throw her right back into a manic or depressed state.
Bipolar disorder is such an unpredictable disease, and that can make caregiving especially tricky. But by taking the following deliberate actions, we were able to help Carey manage the disorder and begin to rebuild her life:
1. Establish Trust
When you're caregiving for someone with bipolar, it's important to establish trust early on. There were a few cases, especially at first, where Carey may have been defensive and interpreted our questions and comments as critical, rather than as an honest effort to raise issues that we needed to address.
But as trust developed and she continued to get better, she came to realize that we had her best interests at heart. Once we established this trust, everything else became so much easier.
2. Manage Expectations
After the first three or four weeks of her living with us, Diana and I recognized the need for some basic ground rules. We felt that laying down a few clear expectations would help give Carey some much-needed structure and stability, while also helping us maintain a certain level of control over the changing dynamics in our household.
It wasn't any magical idea; the goal was simply to establish some simple expectations and to encourage polite but direct conversation. We realized Carey couldn't read our minds. And at the same time, we wanted her to feel free to tell us what we could do-or stop doing-to help her.
3. Get Organized
The first document I made for Carey was a spreadsheet of all of her bills and savings. In her mania, she had spent incredible amounts of money. She'd also racked up a number of hospital and physician charges at several different facilities. We were just trying to organize her finances and determine exactly what her situation was.
It quickly became clear that she owed much more than she had. The natural next step was to lay out a plan for her to settle her obligations and get out of debt. To do that, we knew she needed a job. We helped Carey update her resume so she could find employment, earn an income and get back on her feet financially. Before too long, she found a job and started working at a local hardware store.
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4. Set Goals
After her first year with us, Carey had clearly transitioned well. But just from talking with her, I could tell she was in a new kind of rut. We definitely didn't want to push her out, but we did want to keep pushing her forward, because in a way it was as if she'd become complacent with the current situation.
I thought if we could put some goals on paper where she could see them, she'd have something concrete to move toward. So we worked together to list out what she wanted to accomplish in 2013. It included financial goals, like buying a car and saving up some money, and also more personal goals for her to finalize her divorce and reestablish a career.
There's no guidebook for taking care of someone with bipolar. But by establishing trust and expectations, getting organized and setting goals, Diana and I feel we've been able to give Carey the support she needs.
At this point, I think the greatest thing we can continue to offer is a secure and peaceful home. My biggest fear would be for us to pull the plug before she is ready to go. I don't know if this is the year she moves out or not, and I honestly don't have a strong point of view about it either way. You can't expect a person who's dealing with bipolar disorder to be ready for independence on any timetable you construct.
So many of the people Carey was in treatment with haven't been able to remain stable, and many haven't been able to remain sober. My observation of many of these relapses is that they didn't have a stable home environment or support system. Carey has worked so hard at getting well; the least we could do for her is give her a safe, stress free environment in which to do so.
Kevin lives in Atlanta, Ga., with his wife, Diana, his wife's sister, Carey, and his four sons. A professional background in consulting explains some of his strengths as a caregiver.
Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced
or reprinted without permission from Healthgrades Operating Company, Inc. Use
of this information is governed by the Healthgrades User Agreement.